Purpose

Resection of skull base malignancies that would have been associated with unacceptable morbidity and mortality in the past are now performed with reliable results due in large part to advancements in reconstructive surgery. The goal of this review is to describe the best evidence-based methods of reconstruction following open surgery for skull base tumors in order to attain improved outcomes for patients.

Methods

A review of recent studies involving reconstruction following open skull base surgeries was performed.

Results

Free flaps are now the most commonly recommended method for reconstruction following open skull base surgery, although pedicled regional flaps such as the temporalis muscle, supraclavicular, and submental flaps may be good alternatives in specific cases. Recent series suggest high reconstructive free flap survival rates and low levels of recipient site complications, including neurosurgical complications such as cerebrospinal fluid leak. The location of the resection defect predicts the reconstructive challenges and guides pedicled and free flap selection.

Conclusion

Refinements in flap selection and reconstructive technique continue to improve patient outcomes and decrease complication rates following open surgery for skull base malignancies.

中文翻译：

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颅底恶性肿瘤开放手术后的重建。

目的

颅底恶性肿瘤的切除在过去会带来不可接受的发病率和死亡率，现在进行的切除手术取得了可靠的结果，这在很大程度上要归功于重建手术的进步。本综述的目的是描述颅底肿瘤开放手术后重建的最佳循证方法，以改善患者的预后。

方法

对最近涉及开放颅底手术后重建的研究进行了回顾。

结果

游离皮瓣现在是开放颅底手术后最常推荐的重建方法，尽管有蒂区域皮瓣，如颞肌、锁骨上皮瓣和颏下皮瓣在特定情况下可能是很好的选择。最近的系列表明重建游离皮瓣的存活率高，受体部位并发症水平低，包括脑脊液漏等神经外科并发症。切除缺损的位置可预测重建挑战并指导带蒂皮瓣和游离皮瓣的选择。

结论

皮瓣选择和重建技术的改进继续改善患者的预后并降低颅底恶性肿瘤开放手术后的并发症发生率。